Springer Science and Business Media LLC

To explore the ability of 3D volume measurement to evaluate the ovaries of normal women and women with polycystic ovary syndrome (PCOS). 3D images of the ovaries of 10 patients with polycystic ovary syndrome (PCOS) and 10 normal women with regular menstrual cycles were reconstructed. Three-dimensional ultrasonography was used to calculate ovarian volume, stromal volume, and follicular number in each patient. A Voluson 530D ultrasound system (Medison) with software version 4 was used to obtain the images. The trapezoid formula was used to measure ovary and follicle volume by outlining the areas of multiple parallel sections at different distances from the ovary and follicle. Stromal volume was determined by subtracting the sum volume of the follicles from ovarian volume. Ovarian volume in normal and PCOS women was 5.66±2.30 cm3 and 9.41±3.08 cm3, respectively (P=0.0002); stromal volume was 4.54±1.83 cm3 and 8.31±3.07 cm3, respectively (P=0.0005); and follicular number was 3.55±1.57 and 11.25±4.33, respectively (P=0.0001). Stromal volume and follicular number correlated closely with ovarian volume in PCOS patients (r2=0.944,P=0.0001 and r2=0.486,P=0.006, respectively). Accurate volume measurement with 3D ultrasound allows quantitative evaluation of the ovary. The excellent reconstructive images and convenient volume measurement of 3D ultrasound support its use in obstetrics and gynecology.

Renal circulation evaluation is essential in understanding the cardiorenal relationship in heart failure (HF), and there is a growing interest in imaging techniques that visualize renal circulation. This study aimed to assess the effectiveness of superb microvascular imaging (SMI) in evaluating renal circulation in HF patients. The study included 71 HF patients undergoing cardiac catheterization. Prior to catheterization, renal ultrasound examinations were performed. A control group of 18 subjects without HF was also included. SMI was used to measure the vascular index (VI), which was calculated as the percentage of blood flow signal area in the region of interest. The intrarenal perfusion index (IRPI) was determined as a fluctuation index of VI, reflecting variations in the number of blood cells moving through renal tissue during the cardiac cycle. Using the upper 95% confidence interval of IRPI (0.6) from the control group, HF patients were classified into two groups. Patients with IRPI > 0.6 showed a more congestive profile. Right atrial pressure and biphasic or monophasic Doppler intrarenal flow pattern were independent determinants of IRPI > 0.6. In addition, IRPI remained a significant predictor of estimated glomerular filtration rate (eGFR). The parameter IRPI as variations in SMI signal during the cardiac cycle may be a useful evaluation method for renal perfusion impairment in HF.

The purpose of this study was to investigate the effects of transcatheter closure of atrial septal defects (ASD) on left ventricular function. Conventional and three-dimensional echocardiographic methods (3D) were performed in 20 patients who underwent ASD closure. Diastolic and systolic volumes (LVVd and LVVs) and ejection fractions (EF) were determined by 3D methods. Doppler and tissue Doppler indices were also measured before and 1 day after the procedure. We determined the predictors of patients with a mitral early Doppler/tissue Doppler velocity ratio (E/E′) ≥8 after closure. Ejection fraction decreased (from 70 ± 8 to 63 ± 8%, p = 0.005) after the procedure because of an equivalent increase in LVVs and LVVd maintaining the same cardiac output. Among the echocardiographic variables before ASD closure that correlated with E/E′ after closure, the receiver operating characteristic curve of E′ gave the largest area under the curve with E′ of 12.2 cm/s as the best predictor of patients with E/E′ ≥8 after ASD closure. Atrial septal defect closure decreased EF on the surface, thereby maintaining the same stroke volume and cardiac output. Patients with diastolic dysfunction before closure might have a higher risk of developing congestive heart failure after ASD closure.

It is unclear whether left ventricular (LV) contractile reserve assessed by low-dose dobutamine stress echocardiography (DSE) can predict the long-term prognosis together with LV functional changes in patients with idiopathic dilated cardiomyopathy (DCM). Contractile reserve was determined in 28 patients with DCM, and was then compared with changes in LV fractional shortening (FS) and cardiac events during a follow-up period of 68 ± 43 months. Nine events (2 sudden deaths, 5 heart failure deaths, and 2 rehospitalizations for heart failure) were observed. FS at peak dose was lower in patients with events (events group) than in those without events (no-events group) (20 ± 6 vs. 27 ± 7%; P < 0.05), although there were no differences in FS at baseline between the two groups. FS at follow-up was lower in the events group than in the no-events group (14 ± 7 vs. 21 ± 8%; P < 0.05). The change in FS during DSE (FS at peak dose/baseline) correlated with the change in FS during the follow-up time (FS at follow-up/baseline), and it was a predictor of events by multiple regression analysis. LV contractile reserve assessed by low-dose DSE is a useful marker not only to predict LV functional improvement, but also to determine the long-term prognosis in patients with DCM.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, with an incidence of 20–40% worldwide, making it a major healthcare problem. Because NAFLD can progress to liver fibrosis and cirrhosis through non-alcoholic steatohepatitis, early detection and monitoring of hepatic steatosis are essential for management of NAFLD patients. Even though conventional B-mode ultrasound (US) has been widely used for the evaluation of NAFLD owing to its safety and easy accessibility, its subjective nature and limited accuracy in detecting mild steatosis are major limitations. To overcome the current limitations of conventional B-mode US, attenuation imaging (ATI) based on two-dimensional B-mode US has been developed. ATI can quantitatively assess the degree of hepatic steatosis by calculating the attenuation coefficient, which reflects the degree of US beam attenuation transmitted into the liver tissue. After the first study was published in 2019, several clinical studies using ATI to evaluate hepatic steatosis have reported promising results. In this review, the basic physics, measurement protocol, and reported diagnostic accuracy of ATI in evaluating hepatic steatosis will be discussed.

As a key technology in high-intensity focused ultrasound (HIFU) ablation systems, a precise ultrasound image segmentation method for tumor boundary detection is helpful for ablation of tumors and avoiding tumor recurrence. This study explores a new deformable snake model called multi-scale generalized gradient vector flow (MS-GGVF) to segment ultrasound images in HIFU ablation. The main idea of the technique is dealing with two issues including spurious boundary attenuation and setting the standard deviation of the Gaussian filter. We assign the standard deviation as scales to build the MS-GGVF model and create a signed distance map to use its gradient direction information and magnitude information to refine the multi-scale edge map by attenuating spurious boundaries and highlighting the real boundary. In addition, a fast generalized gradient vector flow computation algorithm based on an augmented Lagrangian method is introduced to calculate the external force vector field to improve the computation efficiency of our model. The experimental segmentations were similar to the ground truths delineated by two medical physicians with high area overlap measure and low mean contour distance. The experimental results demonstrate that the proposed algorithm is robust, reliable, and precise for tumor boundary detection in HIFU ablation systems.

Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory disease of the kidneys. It is characterized by destruction of renal parenchyma and accumulation of lipid-laden foamy macrophages. Diffuse and focal forms are known. The condition is mainly observed in middle-aged women, and it is very rare in childhood. Of 32 nephrectomies carried out in children for various diseases in our hospital over the course of 2 years, there were two cases of diffuse XGP. In both cases, the preoperative diagnosis based on ultrasound findings was highly suggestive of XGP. We present the two cases and define the typical ultrasonographic signs for distinguishing XGP from other renal masses. The diagnostic and therapeutic management is discussed and an overview of the literature is given.